TN 3 (03-95)

A. POLICY

The following subsection provides models of the acknowledgment letters described in GN 03960.035B.4. and GN 03960.055C.7. Dictated letters should be prepared using these model letters as guides.

B. EXHIBITS

Letter AR-1

Acknowledgment Letter - Request for Review - Disapproval of Fee Agreement - to Requester

Letter AR-2

Acknowledgment Letter - Request for Review - Disapproval of Fee Agreement - To Nonrequester

Letter AR-3

Acknowledgment Letter - Request for Review - Fee Resulting From Agreement - To Requester

Letter AR-4

Acknowledgment Letter - Request for Review - Fee Resulting From Agreement - To Nonrequester

Letter AR-5

Acknowledgment Letter - Request for Review - Fee Resulting From Agreement - Received by Wrong Office - Forwarded to Correct Office

Letter AR-6

Acknowledgment Letter - Request for Review - Fee Resulting From Agreement - Good Cause Development

AR-1

Acknowledgment Letter - Request for Review - Disapproval of Fee Agreement - To Requester

 

Ellen Williams
Attorney at Law
Street Address
City/State/ZIP Code

We are writing about your letter dated January 25, 1995. You asked us to review the decision we made on the fee agreement between you and Harry Henderson.

What Will Happen

• Someone who did not make the decision will review it and make a new one. We will give you that decision in writing. If we approve the fee agreement, we will tell you the most you can charge under the agreement for your work on the Social Security claim. If we do not approve the fee agreement and you want to charge a fee, you must ask us in writing to approve the fee amount.

  Because the claimant and the person who disapproved the fee agreement can comment on your request for administrative review, we are sending them copies. They also can provide more information to the person reviewing your request.

  If we need more information, we will contact you. We will give you our decision in writing. We will also send copies of our letter to Harry Henderson and James Kelly ( claims representative ).

If You Have Any Questions

Street Address
City/State/ZIP Code

• If you have questions about this letter, please write us at:

  Address of Originating Component

  If you have questions about other Social Security matters, call us toll free at 1-800-772-1213, 7 a.m. to 7 p.m. Monday through Friday. We can answer most questions over the phone. Our busiest times are the first week of the month and Mondays. So, we may be able to handle your call more quickly if you can call us at other times.

  If you wish, you can call your local Social Security office at xxx-xxxx. You can also write or visit a Social Security office. The office that serves your area is located at:

If you do call or visit an office, please have this letter with you. It will help us answer your questions. This will help us serve you more quickly.

AR-2

Acknowledgment Letter - Request for Review - Disapproval of Fee Agreement - To Nonrequester

Harry Henderson
Street Address
City/State/ZIP Code

Ellen Williams has asked us to review our decision disapproving a fee agreement between you and her.

What Will Happen

Someone who did not make the decision will review it and make a new one. We will give you that decision in writing. If we approve the fee agreement, we will tell you the most your lawyer can charge for her work on your claim. If we do not approve the fee agreement and your lawyer wants to charge a fee, she must ask us in writing to approve the fee amount.

What You Can Do

We are sending you a copy of Ms. Williams letter. If you have comments about the letter, or want to give us more information, write us within 15 days. We will consider what you tell us. You can write us at this address:

Address of Originating Component

If You Have Any Questions

If you have questions about this letter, please write us at the above address.

If you have questions about other Social Security matters, call us toll free at 1-800-772-1213, 7 a.m. to 7 p.m. Monday through Friday. We can answer most questions over the phone. Our busiest times are the first week of the month and Mondays. So, we may be able to handle your call more quickly if you can call us at other times.

If you wish you can call your local Social Security office at xxx-xxxx. You can also write or visit a Social Security office. The office that serves your area is located at:

Street Address
City/State/ZIP Code

If you do call or visit an office, please have this letter with you. It will help us answer your questions. This will help us serve you more quickly.

AR-3

Acknowledgment Letter - Request for Review - Fee Resulting From Agreement - To Requester

Bruce Smith
Street Address
City/State/ZIP Code

We are writing about your letter dated January 25, 1995. You asked us to review the fee amount we said your lawyer, Marvin Levy, can charge for his work under your fee agreement.

What Will Happen

• Someone who did not decide the fee amount will review the decision and make a new one. Based on that review we will raise, lower, or not change the fee amount your lawyer can charge.

  If we lower the fee amount, the lower fee is the most your lawyer can charge under the fee agreement for his work on your Social Security claim. If we raise the fee amount, your lawyer can charge you the higher amount.

  Because Marvin Levy, Susy Smith, Joey Smith, and James Kelly (claims representative) can comment on your request for administrative review, we are sending them a copy of your request. They also can provide more information to the person reviewing your request.

  If we need more information we will contact you. We will send you and the other people listed above, a letter telling what we decide.

If You Have Any Question

See Referral Paragraphs in Model Acknowledgment Letter AR-1

AR-4

Acknowledgment Letter - Request for Review - Fee Resulting From Agreement - To Nonrequester

Sally Brown
Street Address
City/State/ZIP Code

Jane Doe has asked us to raise the fee amount we said she can charge for her work on your claim. She wants us to raise the fee amount from $900 to $1,500.

What Will Happen

Someone who did not decide the fee amount will review the decision and make a new one. Based on that review we will raise, lower, or not change the fee amount your lawyer can charge.

If we lower the fee amount, the lower fee is the most your lawyer can charge under the fee agreement for her work on your Social Security claim. If we raise the fee amount, your lawyer can charge you the higher amount.

What You Can Do

We are sending you a copy of Ms. Doe's letter. If you have comments about the letter, or want to give us more information, write us within 15 days. We will consider what you tell us. You can write us at this address:

Address of Originating Component

If You Have Any Questions

See Referral Paragraphs in Model Acknowledgment Letter AR-2

AR-5

Acknowledgment Letter - Request for Review - Fee Resulting From Agreement - Received by Wrong Office - Forwarded to Correct Office

Abbey Rhodes
Attorney at Law
Street Address
City/State/ZIP Code

We are writing about your letter postmarked May 18, 1995. You asked us to review the fee amount we said you can charge George Harrison under your fee agreement.

What We Have Done

We have sent your letter to the Office of Central Operations, 1500 Woodlawn Drive, Baltimore, MD 21241-1500. Someone in that office will review your request. If you want more information or have questions about the review, please write to that office.

AR-6

Acknowledgment Letter - Request for Review - Fee Resulting From Agreement - Good Cause Development

Jimmy Johnson
Street Address
City/State/ZIP Code

We are writing about your letter dated January 1, 1995. You asked us to review the fee amount we said your lawyer, Charles Yeager, can charge for his work under your fee agreement.

What You Should Do

In our letter dated November 15, 1995, we told you to write to us within 15 days of the day you got the letter if you wanted a review. We assume you got our letter within 5 days after the date on it, unless you show us that you did not get it within the 5-day period.

You did not write us within 15 days, so we will not review our decision unless we decide you had good reason for not asking for review on time. If you think you have a good reason, write us within 15 days from the day you get this letter. Tell us why you did not ask for the review on time. Also, give us any information that might support what you say.

If You Have Any Questions

See Referral Paragraphs in Model Acknowledgment Letter AR-1